1 | The Commerce Council recommends the following: |
2 |
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3 | Council/Committee Substitute |
4 | Remove the entire bill and insert: |
5 | A bill to be entitled |
6 | An act relating to property insurance; creating s. |
7 | 489.1285, F.S.; specifying certain consumer protection |
8 | measures relating to roofing construction to be in effect |
9 | following certain executive orders; specifying certain |
10 | requirements to be complied with relating to roof repair |
11 | or reroofing; amending s. 627.062, F.S.; limiting an |
12 | insurer's recoupment of reimbursement premium; providing |
13 | limitations; amending s. 627.0628, F.S.; limiting use of |
14 | certain methodologies in determining hurricane loss |
15 | factors for reimbursement premium rates in certain rate |
16 | filings; creating s. 627.06281, F.S.; requiring certain |
17 | insurers and organizations to develop, maintain, and |
18 | update a public hurricane loss projection model; providing |
19 | reporting requirements for insurers; protecting trade |
20 | secret information; amending s. 627.0629, F.S.; tightening |
21 | a limitation on rate filings based on computer models |
22 | under certain circumstances; amending s. 627.351, F.S.; |
23 | providing additional legislative intent relating to the |
24 | Citizens Property Insurance Corporation; specifying a |
25 | limitation on dwelling limits for personal lines policies; |
26 | requiring the corporation to offer wind-only policies in |
27 | certain areas for new personal residential risks; |
28 | providing requirements and limitations; requiring creation |
29 | of a Market Accountability Advisory Committee to assist |
30 | the corporation for certain purposes; providing for |
31 | appointment of committee members; providing for terms; |
32 | requiring reports to the corporation; revising |
33 | requirements for the plan of operation of the corporation; |
34 | requiring a plan for removing personal lines policies from |
35 | coverage by the corporation which includes the development |
36 | and implementation of a take-out bonus strategy; deleting |
37 | limitations on certain personal lines residential wind- |
38 | only policies; deleting an obsolete reporting requirement; |
39 | specifying nonapplication of certain policy requirements |
40 | in counties lacking reasonable degrees of competition for |
41 | certain policies under certain circumstances; requiring |
42 | the commission to adopt rules; deleting an obsolete rate |
43 | methodology panel reporting requirement provision; |
44 | requiring the corporation to require the securing of flood |
45 | insurance as a condition of coverage under certain |
46 | circumstances; providing requirements and limitations; |
47 | amending s. 627.411, F.S.; revising grounds for office |
48 | disapproval of certain forms; amending s. 627.7015, F.S.; |
49 | revising purpose and scope provisions relating to an |
50 | alternative procedure for resolution of disputed property |
51 | insurance claims; providing an additional criterion for |
52 | excusing an insured from being required to submit to |
53 | certain loss appraisal processes; amending s. 627.702, |
54 | F.S.; specifying intent; providing nonapplication of |
55 | certain insurer liability requirements under certain |
56 | circumstances; limiting an insurer's liability to certain |
57 | loss covered by a covered peril; amending s. 627.706, |
58 | F.S.; revising definitions relating to sinkholes; |
59 | providing additional definitions; creating s. 627.7065, |
60 | F.S.; providing legislative findings; requiring the |
61 | Department of Financial Services and the Office of the |
62 | Insurance Consumer Advocate to consult with the Florida |
63 | Geological Survey and the Department of Environmental |
64 | Protection to implement a statewide automated database of |
65 | sinkholes and related activity; providing requirements for |
66 | the form and content of the database; authorizing the |
67 | Department of Financial Services to require insurers to |
68 | provide certain information; providing for management of |
69 | the database; requiring the department to investigate |
70 | sinkhole activity reports and include findings and |
71 | investigations in the database; requiring the Department |
72 | of Environmental Protection to report on the database to |
73 | the Governor, Legislature, and Chief Financial Officer; |
74 | authorizing the Department of Financial Services to adopt |
75 | implementing rules; amending s. 627.707, F.S.; revising |
76 | standards for investigations of sinkhole claims by |
77 | insurers; requiring an insurer to engage an engineer and |
78 | professional geologist for certain purposes; requiring a |
79 | report under certain circumstances; requiring an insurer |
80 | to provide written notice to a policyholder disclosing |
81 | certain information; authorizing an insurer to deny a |
82 | claim under certain circumstances; authorizing a |
83 | policyholder to demand certain testing; providing |
84 | requirements; specifying required activities for insurers |
85 | if a sinkhole loss is verified; specifying payment |
86 | requirements for insurers; providing limitations; |
87 | requiring the insurer to pay fees of the engineer and |
88 | geologist; authorizing an insurer to engage a structural |
89 | engineer for certain purposes; creating s. 627.7072, F.S.; |
90 | specifying requirements for sinkhole testing by engineers |
91 | and geologists; creating s. 627.7073, F.S.; providing |
92 | reporting requirements for engineers and geologists after |
93 | testing for sinkholes; specifying a presumption of |
94 | correctness of certain findings; requiring an insurer |
95 | paying a sinkhole loss claim to file a report and |
96 | certification with the county property appraiser; |
97 | requiring the property appraiser to record the report and |
98 | certification; requiring the insurer to bear the cost of |
99 | filing and recording; requiring a seller of certain |
100 | property to make certain disclosures to property buyers |
101 | under certain circumstances; requiring the Auditor General |
102 | to perform an operational audit of the Citizens Property |
103 | Insurance Corporation; specifying audit requirements; |
104 | requiring a report; requiring the board of governors of |
105 | the Citizens Property Insurance Corporation to submit a |
106 | report to the Legislature relating to property and |
107 | casualty insurance; specifying report requirements; |
108 | providing for contingent effect; providing effective |
109 | dates. |
110 |
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111 | Be It Enacted by the Legislature of the State of Florida: |
112 |
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113 | Section 1. Section 489.1285, Florida Statutes, is created |
114 | to read: |
115 | 489.1285 Consumer protections; contract limitations.-- |
116 | Subsequent to the issuance of an executive order by the Office |
117 | of the Governor declaring the existence of a state of emergency |
118 | as a result and consequence of a serious threat posed to the |
119 | public health, safety, and property in this state, in which |
120 | damage to property has occurred and for which property insurance |
121 | claims have been filed, the following consumer protection |
122 | measures shall be in effect: |
123 | (1) A contract for the repair or reroofing of a |
124 | residential structure that has been agreed to in writing by the |
125 | parties to the contract shall be a valid and binding agreement. |
126 | A roofing contractor licensed pursuant to this chapter who is a |
127 | party to a contract for the repair or reroofing of a residential |
128 | structure shall be bound by the qualifications for licensure and |
129 | the job scope specified in this chapter for a roofing contractor |
130 | to provide timely and professional services. |
131 | (2) If a contract is agreed to for the repair of a roof or |
132 | reroofing of a residential structure, which repair is necessary |
133 | as a result of damage caused by an emergency situation |
134 | designated by executive order, the damages must be confirmed by |
135 | a third party who is independent from the parties to the |
136 | contract that the damages are a direct result of a designated |
137 | emergency situation. Third-party confirmation must be attested |
138 | to by an insurance adjuster, emergency management personnel, |
139 | local building official, or other similar authority. |
140 | (3)(a) A contract for services shall not be valid after 60 |
141 | calendar days after the date the contract agreement was signed |
142 | by the parties to the contract. The contract may not provide for |
143 | an automatic extension of time for the provisions of the |
144 | contract. After the 60 days have expired, the contract shall be |
145 | null and void by operation of law. |
146 | (b) Within 10 calendar days after the period of time for |
147 | expiration of the contract, the parties to the contract may |
148 | agree in writing, as a separate contract to the original |
149 | contract, to an additional period of 60 calendar days beyond the |
150 | time period specified in the original contract to complete the |
151 | roofing services. If the performance of services under the |
152 | contract by the roofing contractor have not been completed, the |
153 | contract shall be null and void with no further responsibilities |
154 | or duties on the part of the parties to the contract except as |
155 | provided in this paragraph and subsection (4). |
156 | (c) The subsequent contract may be extended beyond the |
157 | additional 60 days pursuant to a written agreement between the |
158 | parties and signed as an addendum or supplement to the contract. |
159 | The delay or extension of services may only be agreed to if the |
160 | delay in providing the contractual services is due to the |
161 | unavailability, beyond the control of the roofing contractor, of |
162 | roofing materials necessary for the completion of the repair or |
163 | reroofing of the residence. The contracted price of the services |
164 | may not be changed from the agreed to cost specified in the |
165 | subsequent contract. |
166 | (4) Subsequent to the expiration of the contract or |
167 | contracts specified in subsection (3), the contractor shall |
168 | refund and pay in full, upon demand, any and all remuneration |
169 | received in the form of a prepayment, up-front fee, deposit, or |
170 | other consideration already paid to the contractor. |
171 | (5) The provisions of this section apply to registered, as |
172 | well as certified, roofing contractors. |
173 | Section 2. Subsection (5) of section 627.062, Florida |
174 | Statutes, is amended to read: |
175 | 627.062 Rate standards.-- |
176 | (5) With respect to a rate filing involving coverage of |
177 | the type for which the insurer is required to pay a |
178 | reimbursement premium to the Florida Hurricane Catastrophe Fund, |
179 | the insurer may fully recoup in its property insurance premiums |
180 | any reimbursement premiums paid to the Florida Hurricane |
181 | Catastrophe Fund, together with reasonable costs of other |
182 | reinsurance, but may not recoup reinsurance costs that duplicate |
183 | coverage provided by the Florida Hurricane Catastrophe Fund. An |
184 | insurer may not recoup more than one year of reimbursement |
185 | premium at a time. Any under-recoupment from the prior year may |
186 | be added to the following year's reimbursement premium and any |
187 | over-recoupment shall be subtracted from the following year's |
188 | reimbursement premium. |
189 | Section 3. Paragraph (c) of subsection (1) and paragraph |
190 | (c) of subsection (3) of section 627.0628, Florida Statutes, are |
191 | amended to read: |
192 | 627.0628 Florida Commission on Hurricane Loss Projection |
193 | Methodology.-- |
194 | (1) LEGISLATIVE FINDINGS AND INTENT.-- |
195 | (c) It is the intent of the Legislature to create the |
196 | Florida Commission on Hurricane Loss Projection Methodology as a |
197 | panel of experts to provide the most actuarially sophisticated |
198 | guidelines and standards for projection of hurricane losses |
199 | possible, given the current state of actuarial science. It is |
200 | the further intent of the Legislature that such standards and |
201 | guidelines must be used by the State Board of Administration in |
202 | developing reimbursement premium rates for the Florida Hurricane |
203 | Catastrophe Fund, and, subject to paragraph (3)(c), may be used |
204 | by insurers in rate filings under s. 627.062 unless the way in |
205 | which such standards and guidelines were applied by the insurer |
206 | was erroneous, as shown by a preponderance of the evidence. |
207 | (3) ADOPTION AND EFFECT OF STANDARDS AND GUIDELINES.-- |
208 | (c) With respect to a rate filing under s. 627.062, an |
209 | insurer may employ actuarial methods, principles, standards, |
210 | models, or output ranges found by the commission to be accurate |
211 | or reliable to determine hurricane loss factors for use in a |
212 | rate filing under s. 627.062. Such, which findings and factors |
213 | are admissible and relevant in consideration of a rate filing by |
214 | the office or in any arbitration or administrative or judicial |
215 | review only if the office and the consumer advocate appointed |
216 | pursuant to s. 627.0613 have access to all of the assumptions |
217 | and factors that were used in developing the actuarial methods, |
218 | principles, standards, models, or output ranges and are not |
219 | precluded from disclosing such information in a rate proceeding. |
220 | Section 4. Section 627.06281, Florida Statutes, is created |
221 | to read: |
222 | 627.06281 Public hurricane loss projection model; |
223 | reporting of data by insurers.--Within 30 days after a written |
224 | request for loss data and associated exposure data by the office |
225 | or a type I center within the State University System |
226 | established to study mitigation, residential property insurers |
227 | and licensed rating and advisory organizations that compile |
228 | residential property insurance loss data shall provide loss data |
229 | and associated exposure data for residential property insurance |
230 | policies to the office or to a type I center within the State |
231 | University System established to study mitigation, as directed |
232 | by the office, for the purposes of developing, maintaining, and |
233 | updating a public model for hurricane loss projections. The loss |
234 | data and associated exposure data provided shall be in writing. |
235 | Any loss data and associated exposure data provided pursuant to |
236 | this section that constitutes a trade secret as defined in s. |
237 | 812.081, and as provided in s. 815.04(3), shall be subject to |
238 | the provisions of s. 815.045. |
239 | Section 5. Subsection (7) of section 627.0629, Florida |
240 | Statutes, is amended to read: |
241 | 627.0629 Residential property insurance; rate filings.-- |
242 | (7) Any rate filing that is based in whole or part on data |
243 | from a computer model may not exceed 15 25 percent unless there |
244 | is a public hearing. |
245 | Section 6. Paragraphs (a), (c), (d), and (q) of subsection |
246 | (6) of section 627.351, Florida Statutes, are amended to read: |
247 | 627.351 Insurance risk apportionment plans.-- |
248 | (6) CITIZENS PROPERTY INSURANCE CORPORATION.-- |
249 | (a)1. The Legislature finds that actual and threatened |
250 | catastrophic losses to property in this state from hurricanes |
251 | have caused insurers to be unwilling or unable to provide |
252 | property insurance coverage to the extent sought and needed. It |
253 | is in the public interest and a public purpose to assist in |
254 | assuring that property in the state is insured so as to |
255 | facilitate the remediation, reconstruction, and replacement of |
256 | damaged or destroyed property in order to reduce or avoid the |
257 | negative effects otherwise resulting to the public health, |
258 | safety, and welfare; to the economy of the state; and to the |
259 | revenues of the state and local governments needed to provide |
260 | for the public welfare. It is necessary, therefore, to provide |
261 | property insurance to applicants who are in good faith entitled |
262 | to procure insurance through the voluntary market but are unable |
263 | to do so. The Legislature intends by this subsection that |
264 | property insurance be provided and that it continues, as long as |
265 | necessary, through an entity organized to achieve efficiencies |
266 | and economies, while providing service to policyholders, |
267 | applicants, and agents that is no less than the quality |
268 | generally provided in the voluntary market, all toward the |
269 | achievement of the foregoing public purposes. Because it is |
270 | essential for the corporation to have the maximum financial |
271 | resources to pay claims following a catastrophic hurricane, it |
272 | is the intent of the Legislature that the income of the |
273 | corporation be exempt from federal income taxation and that |
274 | interest on the debt obligations issued by the corporation be |
275 | exempt from federal income taxation. |
276 | 2. The Residential Property and Casualty Joint |
277 | Underwriting Association originally created by this statute |
278 | shall be known, as of July 1, 2002, as the Citizens Property |
279 | Insurance Corporation. The corporation shall provide insurance |
280 | for residential and commercial property, for applicants who are |
281 | in good faith entitled, but are unable, to procure insurance |
282 | through the voluntary market. The corporation shall operate |
283 | pursuant to a plan of operation approved by order of the office. |
284 | The plan is subject to continuous review by the office. The |
285 | office may, by order, withdraw approval of all or part of a plan |
286 | if the office determines that conditions have changed since |
287 | approval was granted and that the purposes of the plan require |
288 | changes in the plan. For the purposes of this subsection, |
289 | residential coverage includes both personal lines residential |
290 | coverage, which consists of the type of coverage provided by |
291 | homeowner's, mobile home owner's, dwelling, tenant's, |
292 | condominium unit owner's, and similar policies, and commercial |
293 | lines residential coverage, which consists of the type of |
294 | coverage provided by condominium association, apartment |
295 | building, and similar policies. |
296 | 3. It is the intent of the Legislature that policyholders, |
297 | applicants, and agents of the corporation receive service and |
298 | treatment of the highest possible level but never less than that |
299 | generally provided in the voluntary market. It also is intended |
300 | that the corporation be held to service standards no less than |
301 | those applied to insurers in the voluntary market by the office |
302 | with respect to responsiveness, timeliness, customer courtesy, |
303 | and overall dealings with policyholders, applicants, or agents |
304 | of the corporation. |
305 | (c) The plan of operation of the corporation: |
306 | 1. Must provide for adoption of residential property and |
307 | casualty insurance policy forms and commercial residential and |
308 | nonresidential property insurance forms, which forms must be |
309 | approved by the office prior to use. The corporation shall adopt |
310 | the following policy forms: |
311 | a. Standard personal lines policy forms that are |
312 | comprehensive multiperil policies providing full coverage of a |
313 | residential property equivalent to the coverage provided in the |
314 | private insurance market under an HO-3, HO-4, or HO-6 policy. |
315 | b. Basic personal lines policy forms that are policies |
316 | similar to an HO-8 policy or a dwelling fire policy that provide |
317 | coverage meeting the requirements of the secondary mortgage |
318 | market, but which coverage is more limited than the coverage |
319 | under a standard policy. |
320 | c. Commercial lines residential policy forms that are |
321 | generally similar to the basic perils of full coverage |
322 | obtainable for commercial residential structures in the admitted |
323 | voluntary market. |
324 | d. Personal lines and commercial lines residential |
325 | property insurance forms that cover the peril of wind only. The |
326 | forms are applicable only to residential properties located in |
327 | areas eligible for coverage under the high-risk account referred |
328 | to in sub-subparagraph (b)2.a. |
329 | e. Commercial lines nonresidential property insurance |
330 | forms that cover the peril of wind only. The forms are |
331 | applicable only to nonresidential properties located in areas |
332 | eligible for coverage under the high-risk account referred to in |
333 | sub-subparagraph (b)2.a. |
334 |
|
335 | The dwelling limits for any personal lines policy in both the |
336 | personal lines account and the high-risk account may not exceed |
337 | $1 million. For new personal residential risks written by the |
338 | corporation on or after May 7, 2005, in areas eligible for |
339 | coverage in the high-risk account, the corporation shall offer, |
340 | subject to reasonable underwriting guidelines, a wind only |
341 | policy with building coverage valued at up to $1 million. For |
342 | such new personal residential risks covering properties valued |
343 | at more than $1 million, the corporation shall offer a wind-only |
344 | policy of up to $1 million of building coverage without any |
345 | penalty or reduction in coverage for underinsurance or the |
346 | purchase of other insurance, provided the insured property owner |
347 | maintains insurance coverage for the value of the building in |
348 | excess of $1 million. Coverage for property other than the |
349 | building and any attached structures shall be offered by the |
350 | corporation in addition to the $1 million limit of building |
351 | coverage. For all existing high-risk account policies in effect |
352 | on May 7, 2005, the corporation shall continue to offer coverage |
353 | for the full value of the building and property without |
354 | limitation. |
355 | 2.a. Must provide that the corporation adopt a program in |
356 | which the corporation and authorized insurers enter into quota |
357 | share primary insurance agreements for hurricane coverage, as |
358 | defined in s. 627.4025(2)(a), for eligible risks, and adopt |
359 | property insurance forms for eligible risks which cover the |
360 | peril of wind only. As used in this subsection, the term: |
361 | (I) "Quota share primary insurance" means an arrangement |
362 | in which the primary hurricane coverage of an eligible risk is |
363 | provided in specified percentages by the corporation and an |
364 | authorized insurer. The corporation and authorized insurer are |
365 | each solely responsible for a specified percentage of hurricane |
366 | coverage of an eligible risk as set forth in a quota share |
367 | primary insurance agreement between the corporation and an |
368 | authorized insurer and the insurance contract. The |
369 | responsibility of the corporation or authorized insurer to pay |
370 | its specified percentage of hurricane losses of an eligible |
371 | risk, as set forth in the quota share primary insurance |
372 | agreement, may not be altered by the inability of the other |
373 | party to the agreement to pay its specified percentage of |
374 | hurricane losses. Eligible risks that are provided hurricane |
375 | coverage through a quota share primary insurance arrangement |
376 | must be provided policy forms that set forth the obligations of |
377 | the corporation and authorized insurer under the arrangement, |
378 | clearly specify the percentages of quota share primary insurance |
379 | provided by the corporation and authorized insurer, and |
380 | conspicuously and clearly state that neither the authorized |
381 | insurer nor the corporation may be held responsible beyond its |
382 | specified percentage of coverage of hurricane losses. |
383 | (II) "Eligible risks" means personal lines residential and |
384 | commercial lines residential risks that meet the underwriting |
385 | criteria of the corporation and are located in areas that were |
386 | eligible for coverage by the Florida Windstorm Underwriting |
387 | Association on January 1, 2002. |
388 | b. The corporation may enter into quota share primary |
389 | insurance agreements with authorized insurers at corporation |
390 | coverage levels of 90 percent and 50 percent. |
391 | c. If the corporation determines that additional coverage |
392 | levels are necessary to maximize participation in quota share |
393 | primary insurance agreements by authorized insurers, the |
394 | corporation may establish additional coverage levels. However, |
395 | the corporation's quota share primary insurance coverage level |
396 | may not exceed 90 percent. |
397 | d. Any quota share primary insurance agreement entered |
398 | into between an authorized insurer and the corporation must |
399 | provide for a uniform specified percentage of coverage of |
400 | hurricane losses, by county or territory as set forth by the |
401 | corporation board, for all eligible risks of the authorized |
402 | insurer covered under the quota share primary insurance |
403 | agreement. |
404 | e. Any quota share primary insurance agreement entered |
405 | into between an authorized insurer and the corporation is |
406 | subject to review and approval by the office. However, such |
407 | agreement shall be authorized only as to insurance contracts |
408 | entered into between an authorized insurer and an insured who is |
409 | already insured by the corporation for wind coverage. |
410 | f. For all eligible risks covered under quota share |
411 | primary insurance agreements, the exposure and coverage levels |
412 | for both the corporation and authorized insurers shall be |
413 | reported by the corporation to the Florida Hurricane Catastrophe |
414 | Fund. For all policies of eligible risks covered under quota |
415 | share primary insurance agreements, the corporation and the |
416 | authorized insurer shall maintain complete and accurate records |
417 | for the purpose of exposure and loss reimbursement audits as |
418 | required by Florida Hurricane Catastrophe Fund rules. The |
419 | corporation and the authorized insurer shall each maintain |
420 | duplicate copies of policy declaration pages and supporting |
421 | claims documents. |
422 | g. The corporation board shall establish in its plan of |
423 | operation standards for quota share agreements which ensure that |
424 | there is no discriminatory application among insurers as to the |
425 | terms of quota share agreements, pricing of quota share |
426 | agreements, incentive provisions if any, and consideration paid |
427 | for servicing policies or adjusting claims. |
428 | h. The quota share primary insurance agreement between the |
429 | corporation and an authorized insurer must set forth the |
430 | specific terms under which coverage is provided, including, but |
431 | not limited to, the sale and servicing of policies issued under |
432 | the agreement by the insurance agent of the authorized insurer |
433 | producing the business, the reporting of information concerning |
434 | eligible risks, the payment of premium to the corporation, and |
435 | arrangements for the adjustment and payment of hurricane claims |
436 | incurred on eligible risks by the claims adjuster and personnel |
437 | of the authorized insurer. Entering into a quota sharing |
438 | insurance agreement between the corporation and an authorized |
439 | insurer shall be voluntary and at the discretion of the |
440 | authorized insurer. |
441 | 3. May provide that the corporation may employ or |
442 | otherwise contract with individuals or other entities to provide |
443 | administrative or professional services that may be appropriate |
444 | to effectuate the plan. The corporation shall have the power to |
445 | borrow funds, by issuing bonds or by incurring other |
446 | indebtedness, and shall have other powers reasonably necessary |
447 | to effectuate the requirements of this subsection. The |
448 | corporation may, but is not required to, seek judicial |
449 | validation of its bonds or other indebtedness under chapter 75. |
450 | The corporation may issue bonds or incur other indebtedness, or |
451 | have bonds issued on its behalf by a unit of local government |
452 | pursuant to subparagraph (g)2., in the absence of a hurricane or |
453 | other weather-related event, upon a determination by the |
454 | corporation, subject to approval by the office, that such action |
455 | would enable it to efficiently meet the financial obligations of |
456 | the corporation and that such financings are reasonably |
457 | necessary to effectuate the requirements of this subsection. The |
458 | corporation is authorized to take all actions needed to |
459 | facilitate tax-free status for any such bonds or indebtedness, |
460 | including formation of trusts or other affiliated entities. The |
461 | corporation shall have the authority to pledge assessments, |
462 | projected recoveries from the Florida Hurricane Catastrophe |
463 | Fund, other reinsurance recoverables, market equalization and |
464 | other surcharges, and other funds available to the corporation |
465 | as security for bonds or other indebtedness. In recognition of |
466 | s. 10, Art. I of the State Constitution, prohibiting the |
467 | impairment of obligations of contracts, it is the intent of the |
468 | Legislature that no action be taken whose purpose is to impair |
469 | any bond indenture or financing agreement or any revenue source |
470 | committed by contract to such bond or other indebtedness. |
471 | 4.a. Must require that the corporation operate subject to |
472 | the supervision and approval of a board of governors consisting |
473 | of 7 individuals who are residents of this state, from different |
474 | geographical areas of this state, appointed by the Chief |
475 | Financial Officer. The Chief Financial Officer shall designate |
476 | one of the appointees as chair. All board members serve at the |
477 | pleasure of the Chief Financial Officer. All board members, |
478 | including the chair, must be appointed to serve for 3-year terms |
479 | beginning annually on a date designated by the plan. Any board |
480 | vacancy shall be filled for the unexpired term by the Chief |
481 | Financial Officer. The Chief Financial Officer shall appoint a |
482 | technical advisory group to provide information and advice to |
483 | the board of governors in connection with the board's duties |
484 | under this subsection. The executive director and senior |
485 | managers of the corporation shall be engaged by the Chief |
486 | Financial Officer and serve at the pleasure of the Chief |
487 | Financial Officer. The executive director is responsible for |
488 | employing other staff as the corporation may require, subject to |
489 | review and concurrence by the office of the Chief Financial |
490 | Officer. |
491 | b. The board shall create a Market Accountability Advisory |
492 | Committee to assist the corporation in developing awareness of |
493 | its rates and its customer and agent service levels in |
494 | relationship to the voluntary market insurers writing similar |
495 | coverage. The members of the advisory committee shall consist of |
496 | the following 11 persons, one of whom must be elected chair by |
497 | the members of the committee: four representatives, one |
498 | appointed by the Florida Association of Insurance Agents, one by |
499 | the Florida Association of Insurance and Financial Advisors, one |
500 | by the Professional Insurance Agents of Florida, and one by the |
501 | Latin American Association of Insurance Agencies; three |
502 | representatives appointed by the insurers with the three highest |
503 | voluntary market share of residential property insurance |
504 | business in the state; one representative from the Office of |
505 | Insurance Regulation; one consumer appointed by the board who is |
506 | insured by the corporation at the time of appointment to the |
507 | committee; one representative appointed by the Florida |
508 | Association of Realtors; and one representative appointed by the |
509 | Florida Bankers Association. All members must serve for 3-year |
510 | terms and may serve for consecutive terms. The committee shall |
511 | report to the corporation at each board meeting on insurance |
512 | market issues which may include rates and rate competition with |
513 | the voluntary market; service, including policy issuance, claims |
514 | processing, and general responsiveness to policyholders, |
515 | applicants, and agents; and matters relating to depopulation. |
516 | 5. Must provide a procedure for determining the |
517 | eligibility of a risk for coverage, as follows: |
518 | a. Subject to the provisions of s. 627.3517, with respect |
519 | to personal lines residential risks, if the risk is offered |
520 | coverage from an authorized insurer at the insurer's approved |
521 | rate under either a standard policy including wind coverage or, |
522 | if consistent with the insurer's underwriting rules as filed |
523 | with the office, a basic policy including wind coverage, the |
524 | risk is not eligible for any policy issued by the corporation. |
525 | If the risk is not able to obtain any such offer, the risk is |
526 | eligible for either a standard policy including wind coverage or |
527 | a basic policy including wind coverage issued by the |
528 | corporation; however, if the risk could not be insured under a |
529 | standard policy including wind coverage regardless of market |
530 | conditions, the risk shall be eligible for a basic policy |
531 | including wind coverage unless rejected under subparagraph 8. |
532 | The corporation shall determine the type of policy to be |
533 | provided on the basis of objective standards specified in the |
534 | underwriting manual and based on generally accepted underwriting |
535 | practices. |
536 | (I) If the risk accepts an offer of coverage through the |
537 | market assistance plan or an offer of coverage through a |
538 | mechanism established by the corporation before a policy is |
539 | issued to the risk by the corporation or during the first 30 |
540 | days of coverage by the corporation, and the producing agent who |
541 | submitted the application to the plan or to the corporation is |
542 | not currently appointed by the insurer, the insurer shall: |
543 | (A) Pay to the producing agent of record of the policy, |
544 | for the first year, an amount that is the greater of the |
545 | insurer's usual and customary commission for the type of policy |
546 | written or a fee equal to the usual and customary commission of |
547 | the corporation; or |
548 | (B) Offer to allow the producing agent of record of the |
549 | policy to continue servicing the policy for a period of not less |
550 | than 1 year and offer to pay the agent the greater of the |
551 | insurer's or the corporation's usual and customary commission |
552 | for the type of policy written. |
553 |
|
554 | If the producing agent is unwilling or unable to accept |
555 | appointment, the new insurer shall pay the agent in accordance |
556 | with sub-sub-sub-subparagraph (A). |
557 | (II) When the corporation enters into a contractual |
558 | agreement for a take-out plan, the producing agent of record of |
559 | the corporation policy is entitled to retain any unearned |
560 | commission on the policy, and the insurer shall: |
561 | (A) Pay to the producing agent of record of the |
562 | corporation policy, for the first year, an amount that is the |
563 | greater of the insurer's usual and customary commission for the |
564 | type of policy written or a fee equal to the usual and customary |
565 | commission of the corporation; or |
566 | (B) Offer to allow the producing agent of record of the |
567 | corporation policy to continue servicing the policy for a period |
568 | of not less than 1 year and offer to pay the agent the greater |
569 | of the insurer's or the corporation's usual and customary |
570 | commission for the type of policy written. |
571 |
|
572 | If the producing agent is unwilling or unable to accept |
573 | appointment, the new insurer shall pay the agent in accordance |
574 | with sub-sub-sub-subparagraph (A). |
575 | b. With respect to commercial lines residential risks, if |
576 | the risk is offered coverage under a policy including wind |
577 | coverage from an authorized insurer at its approved rate, the |
578 | risk is not eligible for any policy issued by the corporation. |
579 | If the risk is not able to obtain any such offer, the risk is |
580 | eligible for a policy including wind coverage issued by the |
581 | corporation. |
582 | (I) If the risk accepts an offer of coverage through the |
583 | market assistance plan or an offer of coverage through a |
584 | mechanism established by the corporation before a policy is |
585 | issued to the risk by the corporation or during the first 30 |
586 | days of coverage by the corporation, and the producing agent who |
587 | submitted the application to the plan or the corporation is not |
588 | currently appointed by the insurer, the insurer shall: |
589 | (A) Pay to the producing agent of record of the policy, |
590 | for the first year, an amount that is the greater of the |
591 | insurer's usual and customary commission for the type of policy |
592 | written or a fee equal to the usual and customary commission of |
593 | the corporation; or |
594 | (B) Offer to allow the producing agent of record of the |
595 | policy to continue servicing the policy for a period of not less |
596 | than 1 year and offer to pay the agent the greater of the |
597 | insurer's or the corporation's usual and customary commission |
598 | for the type of policy written. |
599 |
|
600 | If the producing agent is unwilling or unable to accept |
601 | appointment, the new insurer shall pay the agent in accordance |
602 | with sub-sub-sub-subparagraph (A). |
603 | (II) When the corporation enters into a contractual |
604 | agreement for a take-out plan, the producing agent of record of |
605 | the corporation policy is entitled to retain any unearned |
606 | commission on the policy, and the insurer shall: |
607 | (A) Pay to the producing agent of record of the |
608 | corporation policy, for the first year, an amount that is the |
609 | greater of the insurer's usual and customary commission for the |
610 | type of policy written or a fee equal to the usual and customary |
611 | commission of the corporation; or |
612 | (B) Offer to allow the producing agent of record of the |
613 | corporation policy to continue servicing the policy for a period |
614 | of not less than 1 year and offer to pay the agent the greater |
615 | of the insurer's or the corporation's usual and customary |
616 | commission for the type of policy written. |
617 |
|
618 | If the producing agent is unwilling or unable to accept |
619 | appointment, the new insurer shall pay the agent in accordance |
620 | with sub-sub-sub-subparagraph (A). |
621 | 6. Must include rules for classifications of risks and |
622 | rates therefor. |
623 | 7. Must provide that if premium and investment income for |
624 | an account attributable to a particular calendar year are in |
625 | excess of projected losses and expenses for the account |
626 | attributable to that year, such excess shall be held in surplus |
627 | in the account. Such surplus shall be available to defray |
628 | deficits in that account as to future years and shall be used |
629 | for that purpose prior to assessing assessable insurers and |
630 | assessable insureds as to any calendar year. |
631 | 8. Must provide objective criteria and procedures to be |
632 | uniformly applied for all applicants in determining whether an |
633 | individual risk is so hazardous as to be uninsurable. In making |
634 | this determination and in establishing the criteria and |
635 | procedures, the following shall be considered: |
636 | a. Whether the likelihood of a loss for the individual |
637 | risk is substantially higher than for other risks of the same |
638 | class; and |
639 | b. Whether the uncertainty associated with the individual |
640 | risk is such that an appropriate premium cannot be determined. |
641 |
|
642 | The acceptance or rejection of a risk by the corporation shall |
643 | be construed as the private placement of insurance, and the |
644 | provisions of chapter 120 shall not apply. |
645 | 9. Must provide that the corporation shall make its best |
646 | efforts to procure catastrophe reinsurance at reasonable rates, |
647 | to cover its projected 100-year probable maximum loss as |
648 | determined by the board of governors. |
649 | 10. Must provide that in the event of regular deficit |
650 | assessments under sub-subparagraph (b)3.a. or sub-subparagraph |
651 | (b)3.b., in the personal lines account, the commercial lines |
652 | residential account, or the high-risk account, the corporation |
653 | shall levy upon corporation policyholders in its next rate |
654 | filing, or by a separate rate filing solely for this purpose, a |
655 | market equalization surcharge arising from a regular assessment |
656 | in such account in a percentage equal to the total amount of |
657 | such regular assessments divided by the aggregate statewide |
658 | direct written premium for subject lines of business for the |
659 | prior calendar year. Market equalization surcharges under this |
660 | subparagraph are not considered premium and are not subject to |
661 | commissions, fees, or premium taxes; however, failure to pay a |
662 | market equalization surcharge shall be treated as failure to pay |
663 | premium. |
664 | 11. The policies issued by the corporation must provide |
665 | that, if the corporation or the market assistance plan obtains |
666 | an offer from an authorized insurer to cover the risk at its |
667 | approved rates, the risk is no longer eligible for renewal |
668 | through the corporation. |
669 | 12. Corporation policies and applications must include a |
670 | notice that the corporation policy could, under this section, be |
671 | replaced with a policy issued by an authorized insurer that does |
672 | not provide coverage identical to the coverage provided by the |
673 | corporation. The notice shall also specify that acceptance of |
674 | corporation coverage creates a conclusive presumption that the |
675 | applicant or policyholder is aware of this potential. |
676 | 13. May establish, subject to approval by the office, |
677 | different eligibility requirements and operational procedures |
678 | for any line or type of coverage for any specified county or |
679 | area if the board determines that such changes to the |
680 | eligibility requirements and operational procedures are |
681 | justified due to the voluntary market being sufficiently stable |
682 | and competitive in such area or for such line or type of |
683 | coverage and that consumers who, in good faith, are unable to |
684 | obtain insurance through the voluntary market through ordinary |
685 | methods would continue to have access to coverage from the |
686 | corporation. When coverage is sought in connection with a real |
687 | property transfer, such requirements and procedures shall not |
688 | provide for an effective date of coverage later than the date of |
689 | the closing of the transfer as established by the transferor, |
690 | the transferee, and, if applicable, the lender. |
691 | 14. Must provide that, with respect to the high-risk |
692 | account, any assessable insurer with a surplus as to |
693 | policyholders of $25 million or less writing 25 percent or more |
694 | of its total countrywide property insurance premiums in this |
695 | state may petition the office, within the first 90 days of each |
696 | calendar year, to qualify as a limited apportionment company. In |
697 | no event shall a limited apportionment company be required to |
698 | participate in the portion of any assessment, within the high- |
699 | risk account, pursuant to sub-subparagraph (b)3.a. or sub- |
700 | subparagraph (b)3.b. in the aggregate which exceeds $50 million |
701 | after payment of available high-risk account funds in any |
702 | calendar year. However, a limited apportionment company shall |
703 | collect from its policyholders any emergency assessment imposed |
704 | under sub-subparagraph (b)3.d. The plan shall provide that, if |
705 | the office determines that any regular assessment will result in |
706 | an impairment of the surplus of a limited apportionment company, |
707 | the office may direct that all or part of such assessment be |
708 | deferred as provided in subparagraph (g)4. However, there shall |
709 | be no limitation or deferment of an emergency assessment to be |
710 | collected from policyholders under sub-subparagraph (b)3.d. |
711 | 15. Must provide that the corporation appoint as its |
712 | licensed agents only those agents who also hold an appointment |
713 | as defined in s. 626.015(3) with an insurer who at the time of |
714 | the agent's initial appointment by the corporation is authorized |
715 | to write and is actually writing personal lines residential |
716 | property coverage, commercial residential property coverage, or |
717 | commercial nonresidential property coverage within the state. |
718 | 16. Must provide a plan for removing personal lines |
719 | policies from coverage by the corporation which includes the |
720 | development and implementation of a take-out bonus strategy |
721 | determining, at a minimum, the necessity and application of |
722 | financial and regulatory incentives. |
723 | (d)1. It is the intent of the Legislature that the rates |
724 | for coverage provided by the corporation be actuarially sound |
725 | and not competitive with approved rates charged in the admitted |
726 | voluntary market, so that the corporation functions as a |
727 | residual market mechanism to provide insurance only when the |
728 | insurance cannot be procured in the voluntary market. Rates |
729 | shall include an appropriate catastrophe loading factor that |
730 | reflects the actual catastrophic exposure of the corporation. |
731 | 2. For each county, the average rates of the corporation |
732 | for each line of business for personal lines residential |
733 | policies excluding rates for wind-only policies shall be no |
734 | lower than the average rates charged by the insurer that had the |
735 | highest average rate in that county among the 20 insurers with |
736 | the greatest total direct written premium in the state for that |
737 | line of business in the preceding year, except that with respect |
738 | to mobile home coverages, the average rates of the corporation |
739 | shall be no lower than the average rates charged by the insurer |
740 | that had the highest average rate in that county among the 5 |
741 | insurers with the greatest total written premium for mobile home |
742 | owner's policies in the state in the preceding year. |
743 | 3. Rates for personal lines residential wind-only policies |
744 | must be actuarially sound and not competitive with approved |
745 | rates charged by authorized insurers. However, for personal |
746 | lines residential wind-only policies issued or renewed between |
747 | July 1, 2002, and June 30, 2003, the maximum premium increase |
748 | must be no greater than 10 percent of the Florida Windstorm |
749 | Underwriting Association premium for that policy in effect on |
750 | June 30, 2002, as adjusted for coverage changes and seasonal |
751 | occupancy surcharges. For personal lines residential wind-only |
752 | policies issued or renewed between July 1, 2003, and June 30, |
753 | 2004, the corporation shall use its existing filed and approved |
754 | wind-only rating and classification plans, provided, however, |
755 | that the maximum premium increase must be no greater than 20 |
756 | percent of the premium for that policy in effect on June 30, |
757 | 2003, as adjusted for coverage changes and seasonal occupancy |
758 | surcharges. Corporation rate manuals shall include a rate |
759 | surcharge for seasonal occupancy. To ensure that personal lines |
760 | residential wind-only rates effective on or after July 1, 2004, |
761 | are not competitive with approved rates charged by authorized |
762 | insurers, the corporation, in conjunction with the office, shall |
763 | develop a wind-only ratemaking methodology, which methodology |
764 | shall be contained in each a rate filing made by the corporation |
765 | with the office by January 1, 2004. If the office thereafter |
766 | determines that the wind-only rates or rating factors filed by |
767 | the corporation fail to comply with the wind-only ratemaking |
768 | methodology provided for in this subsection, it shall so notify |
769 | the corporation and require the corporation to amend its rates |
770 | or rating factors to come into compliance within 90 days of |
771 | notice from the office. The office shall report to the Speaker |
772 | of the House of Representatives and the President of the Senate |
773 | on the provisions of the wind-only ratemaking methodology by |
774 | January 31, 2004. |
775 | 4. The provisions of subparagraph 2. do not apply to |
776 | coverage provided by the corporation in any county for which the |
777 | office determines that a reasonable degree of competition does |
778 | not exist for personal lines residential policies. The |
779 | provisions of subparagraph 3. do not apply to coverage provided |
780 | by the corporation in any county for which the office determines |
781 | that a reasonable degree of competition does not exist for |
782 | personal lines residential policies in the area of that county |
783 | which is eligible for wind-only coverage. In such counties, the |
784 | rates for personal lines residential coverage shall be |
785 | actuarially sound and not excessive, inadequate, or unfairly |
786 | discriminatory and are subject to the other provisions of the |
787 | paragraph and s. 627.062. The commission shall adopt rules |
788 | establishing the criteria for determining whether a reasonable |
789 | degree of competition exists for personal lines residential |
790 | policies. Beginning October 1, 2005, and each 6 months |
791 | thereafter, the office shall determine and identify those |
792 | counties for which a reasonable degree of competition does not |
793 | exist for purposes of subparagraphs 2. and 3., respectively. |
794 | 5.4. Rates for commercial lines coverage shall not be |
795 | subject to the requirements of subparagraph 2., but shall be |
796 | subject to all other requirements of this paragraph and s. |
797 | 627.062. |
798 | 6.5. Nothing in this paragraph shall require or allow the |
799 | corporation to adopt a rate that is inadequate under s. 627.062. |
800 | 7.6. The corporation shall certify to the office at least |
801 | twice annually that its personal lines rates comply with the |
802 | requirements of this paragraph subparagraphs 1. and 2. If any |
803 | adjustment in the rates or rating factors of the corporation is |
804 | necessary to ensure such compliance, the corporation shall make |
805 | and implement such adjustments and file its revised rates and |
806 | rating factors with the office. If the office thereafter |
807 | determines that the revised rates and rating factors fail to |
808 | comply with the provisions of this paragraph subparagraphs 1. |
809 | and 2., it shall notify the corporation and require the |
810 | corporation to amend its rates or rating factors in conjunction |
811 | with its next rate filing. The office must notify the |
812 | corporation by electronic means of any rate filing it approves |
813 | for any insurer among the insurers referred to in subparagraph |
814 | 2. |
815 | 8.7. In addition to the rates otherwise determined |
816 | pursuant to this paragraph, the corporation shall impose and |
817 | collect an amount equal to the premium tax provided for in s. |
818 | 624.509 to augment the financial resources of the corporation. |
819 | 9.8.a. To assist the corporation in developing additional |
820 | ratemaking methods to assure compliance with this paragraph |
821 | subparagraphs 1. and 4., the corporation shall appoint a rate |
822 | methodology panel consisting of one person recommended by the |
823 | Florida Association of Insurance Agents, one person recommended |
824 | by the Professional Insurance Agents of Florida, one person |
825 | recommended by the Florida Association of Insurance and |
826 | Financial Advisors, one person recommended by the insurer with |
827 | the highest voluntary market share of residential property |
828 | insurance business in the state, one person recommended by the |
829 | insurer with the second-highest voluntary market share of |
830 | residential property insurance business in the state, one person |
831 | recommended by an insurer writing commercial residential |
832 | property insurance in this state, one person recommended by the |
833 | Office of Insurance Regulation, and one board member designated |
834 | by the board chairman, who shall serve as chairman of the panel. |
835 | b. By January 1, 2004, the rate methodology panel shall |
836 | provide a report to the corporation of its findings and |
837 | recommendations for the use of additional ratemaking methods and |
838 | procedures, including the use of a rate equalization surcharge |
839 | in an amount sufficient to assure that the total cost of |
840 | coverage for policyholders or applicants to the corporation is |
841 | sufficient to comply with subparagraph 1. |
842 | c. Within 30 days after such report, the corporation shall |
843 | present to the President of the Senate, the Speaker of the House |
844 | of Representatives, the minority party leaders of each house of |
845 | the Legislature, and the chairs of the standing committees of |
846 | each house of the Legislature having jurisdiction of insurance |
847 | issues, a plan for implementing the additional ratemaking |
848 | methods and an outline of any legislation needed to facilitate |
849 | use of the new methods. |
850 | d. The plan must include a provision that producer |
851 | commissions paid by the corporation shall not be calculated in |
852 | such a manner as to include any rate equalization surcharge. |
853 | However, without regard to the plan to be developed or its |
854 | implementation, producer commissions paid by the corporation for |
855 | each account, other than the quota share primary program, shall |
856 | remain fixed as to percentage, effective rate, calculation, and |
857 | payment method until January 1, 2004. |
858 | 10.9. By January 1, 2004, The corporation shall develop a |
859 | notice to policyholders or applicants that the rates of Citizens |
860 | Property Insurance Corporation are intended to be higher than |
861 | the rates of any admitted carrier except when the provisions of |
862 | subparagraph 4. apply and providing other information the |
863 | corporation deems necessary to assist consumers in finding other |
864 | voluntary admitted insurers willing to insure their property. |
865 | (q) The corporation shall not require the securing of |
866 | flood insurance as a condition of coverage if the property risk |
867 | of the insured or applicant is located in a Special Flood Hazard |
868 | Area as defined by the Federal Emergency Management Agency for |
869 | the National Flood Insurance Program. executes a form approved |
870 | by the office affirming that Flood insurance is not provided by |
871 | the corporation and that if flood insurance is not secured by |
872 | the applicant or insured in addition to coverage by the |
873 | corporation, the risk will not be covered for flood damage. A |
874 | corporation policyholder that does electing not to secure flood |
875 | insurance and makes a claim executing a form as provided herein |
876 | making a claim for water damage against the corporation shall |
877 | have the burden of proving the damage was not caused by |
878 | flooding. Notwithstanding other provisions of this subsection, |
879 | the corporation may deny coverage or refuse to issue or renew a |
880 | policy to an applicant or insured who refuses to purchase flood |
881 | insurance as required by this subsection to execute the form |
882 | described herein. |
883 | Section 7. Subsection (1) of section 627.411, Florida |
884 | Statutes, is amended to read: |
885 | 627.411 Grounds for disapproval.-- |
886 | (1) The office shall disapprove any form filed under s. |
887 | 627.410, or withdraw any previous approval thereof, only if the |
888 | form: |
889 | (a) Is in any respect in violation of, or does not comply |
890 | with, this code. |
891 | (b) Contains or incorporates by reference, where such |
892 | incorporation is otherwise permissible, any inconsistent, |
893 | ambiguous, or misleading clauses, or exceptions and conditions |
894 | which deceptively affect the risk purported to be assumed in the |
895 | general coverage of the contract. |
896 | (c) Has any title, heading, or other indication of its |
897 | provisions which is misleading. |
898 | (d) Is printed or otherwise reproduced in such manner as |
899 | to render any material provision of the form substantially |
900 | illegible. |
901 | (e) Is for property insurance and contains provisions that |
902 | are unfair or inequitable or contrary to the public policy of |
903 | this state or that encourage misrepresentation. |
904 | (f)(e) Is for health insurance, and: |
905 | 1. Provides benefits that are unreasonable in relation to |
906 | the premium charged.; |
907 | 2. Contains provisions that are unfair or inequitable or |
908 | contrary to the public policy of this state or that encourage |
909 | misrepresentation.; |
910 | 3. Contains provisions that apply rating practices that |
911 | result in unfair discrimination pursuant to s. 626.9541(1)(g)2. |
912 | (g)(f) Excludes coverage for human immunodeficiency virus |
913 | infection or acquired immune deficiency syndrome or contains |
914 | limitations in the benefits payable, or in the terms or |
915 | conditions of such contract, for human immunodeficiency virus |
916 | infection or acquired immune deficiency syndrome which are |
917 | different than those which apply to any other sickness or |
918 | medical condition. |
919 | Section 8. Subsections (1) and (7) of section 627.7015, |
920 | Florida Statutes, are amended to read: |
921 | 627.7015 Alternative procedure for resolution of disputed |
922 | property insurance claims.-- |
923 | (1) PURPOSE AND SCOPE.--This section sets forth a |
924 | nonadversarial alternative dispute resolution procedure for a |
925 | mediated claim resolution conference prompted by the need for |
926 | effective, fair, and timely handling of property insurance |
927 | claims. There is a particular need for an informal, |
928 | nonthreatening forum for helping parties who elect this |
929 | procedure to resolve their claims disputes because most |
930 | homeowner's and commercial residential insurance policies |
931 | obligate insureds to participate in a potentially expensive and |
932 | time-consuming adversarial appraisal process prior to |
933 | litigation. The procedure set forth in this section is designed |
934 | to bring the parties together for a mediated claims settlement |
935 | conference without any of the trappings or drawbacks of an |
936 | adversarial process. Before resorting to these procedures, |
937 | insureds and insurers are encouraged to resolve claims as |
938 | quickly and fairly as possible. This section is available with |
939 | respect to claims under personal lines and commercial |
940 | residential policies for all claimants and insurers prior to |
941 | commencing the appraisal process, or commencing litigation. If |
942 | requested by the insured, participation by legal counsel shall |
943 | be permitted. Mediation under this section is also available to |
944 | litigants referred to the department by a county court or |
945 | circuit court. This section does not apply to commercial |
946 | coverages, to private passenger motor vehicle insurance |
947 | coverages, or to disputes relating to liability coverages in |
948 | policies of property insurance. |
949 | (7) If the insurer fails to comply with subsection (2) by |
950 | failing to notify a first-party claimant of its right to |
951 | participate in the mediation program under this section or if |
952 | the insurer requests the mediation, and the mediation results |
953 | are rejected by either party, the insured shall not be required |
954 | to submit to or participate in any contractual loss appraisal |
955 | process of the property loss damage as a precondition to legal |
956 | action for breach of contract against the insurer for its |
957 | failure to pay the policyholder's claims covered by the policy. |
958 | Section 9. Effective upon this act becoming a law, |
959 | subsection (1) of section 627.702, Florida Statutes, is amended |
960 | to read: |
961 | 627.702 Valued policy law.-- |
962 | (1)(a) In the event of the total loss of any building, |
963 | structure, mobile home as defined in s. 320.01(2), or |
964 | manufactured building as defined in s. 553.36(12), located in |
965 | this state and insured by any insurer as to a covered peril, in |
966 | the absence of any change increasing the risk without the |
967 | insurer's consent and in the absence of fraudulent or criminal |
968 | fault on the part of the insured or one acting in her or his |
969 | behalf, the insurer's liability, if any, under the policy for |
970 | such total loss, if caused by a covered peril, shall be in the |
971 | amount of money for which such property was so insured as |
972 | specified in the policy and for which a premium has been charged |
973 | and paid. |
974 | (b) The intent of this subsection is not to deprive an |
975 | insurer of any proper defense under the policy, to create new or |
976 | additional coverage under the policy, or to require an insurer |
977 | to pay for a loss caused by a peril other than the covered |
978 | peril. In furtherance of such legislative intent, when a loss |
979 | was caused in part by a covered peril and in part by a |
980 | noncovered peril, paragraph (a) does not apply. In such |
981 | circumstances, the insurer's liability under this section shall |
982 | be limited to the amount of the loss caused by the covered |
983 | peril. |
984 | Section 10. Section 627.706, Florida Statutes, is amended |
985 | to read: |
986 | 627.706 Sinkhole insurance; definitions.-- |
987 | (1) Every insurer authorized to transact property |
988 | insurance in this state shall make available coverage for |
989 | insurable sinkhole losses on any structure, including contents |
990 | of personal property contained therein, to the extent provided |
991 | in the form to which the sinkhole coverage attaches. |
992 | (2) As used in ss. 627.706-627.7074, and as used in |
993 | connection with any policy providing coverage for sinkhole |
994 | losses: |
995 | (a) "Sinkhole" means a landform created by subsidence of |
996 | soil, sediment, or rock as underlying strata are dissolved by |
997 | ground water. A sinkhole may form by collapse into subterranean |
998 | voids created by dissolution of limestone or dolostone or by |
999 | subsidence as these strata are dissolved. |
1000 | (b) "Sinkhole loss" means structural damage to a the |
1001 | building caused by sinkhole activity. Contents coverage shall |
1002 | apply only if there is structural damage to the building caused |
1003 | by sinkhole activity. |
1004 | (c)(3) "Sinkhole activity loss" means actual physical |
1005 | damage to the property covered arising out of or caused by |
1006 | sudden settlement or systematic weakening collapse of the earth |
1007 | supporting such property only when such settlement or systematic |
1008 | weakening collapse results from movement or raveling of soils, |
1009 | sediments, or rock materials into subterranean voids created by |
1010 | the effect action of water on a limestone or similar rock |
1011 | formation. |
1012 | (d) "Engineer" means a person, as defined in s. 471.005, |
1013 | who has a bachelor's degree or higher in engineering with a |
1014 | specialty in the geotechnical engineering field. An engineer |
1015 | must have geotechnical experience and expertise in the |
1016 | identification of sinkhole activity as well as other potential |
1017 | causes of damage to the structure. |
1018 | (e) "Professional geologist" means a person, as defined by |
1019 | s. 492.102, who has a bachelor's degree or higher in geology or |
1020 | a related earth science with expertise in the geology of this |
1021 | state. A professional geologist must have geological experience |
1022 | and expertise in the identification of sinkhole activity as well |
1023 | as other potential causes of damage to the structure. |
1024 | (3)(4) Every insurer authorized to transact property |
1025 | insurance in this state shall make a proper filing with the |
1026 | office for the purpose of extending the appropriate forms of |
1027 | property insurance to include coverage for insurable sinkhole |
1028 | losses. |
1029 | Section 11. Section 627.7065, Florida Statutes, is created |
1030 | to read: |
1031 | 627.7065 Database of information relating to sinkholes; |
1032 | the Department of Financial Services and the Department of |
1033 | Environmental Protection.-- |
1034 | (1) The Legislature finds that there has been a dramatic |
1035 | increase in the number of sinkholes and insurance claims for |
1036 | sinkhole damage in the state during the past 10 years. |
1037 | Accordingly, the Legislature recognizes the need to track |
1038 | current and past sinkhole activity and to make the information |
1039 | available for prevention and remediation activities. The |
1040 | Legislature further finds that the Florida Geological Survey of |
1041 | the Department of Environmental Protection has created a partial |
1042 | database of some sinkholes identified in Florida, although the |
1043 | database is not reflective of all sinkholes or insurance claims |
1044 | for sinkhole damage. The Legislature determines that creating a |
1045 | complete electronic database of sinkhole activity serves an |
1046 | important purpose in protecting the public and in studying |
1047 | property claims activities in the insurance industry. |
1048 | (2) The Department of Financial Services, including the |
1049 | employee of the Division of Consumer Services designated as the |
1050 | primary contact for consumers on issues relating to sinkholes, |
1051 | and the Office of the Insurance Consumer Advocate shall consult |
1052 | with the Florida Geological Survey and the Department of |
1053 | Environmental Protection to implement a statewide automated |
1054 | database of sinkholes and related activity identified in the |
1055 | state. |
1056 | (3) Representatives of the Department of Financial |
1057 | Services, with the agreement of the Department of Environmental |
1058 | Protection, shall determine the form and content of the |
1059 | database. The content may include standards for reporting and |
1060 | investigating sinkholes for inclusion in the database and |
1061 | requirements for insurers to report to the departments the |
1062 | receipt of claims involving sinkhole loss and other similar |
1063 | activities. The Department of Financial Services may require |
1064 | insurers to report present and past data of sinkhole claims. The |
1065 | database also may include information of damage due to ground |
1066 | settling and other subsidence activity. |
1067 | (4) The Department of Financial Services may manage the |
1068 | database or may contract for its management and maintenance. The |
1069 | Department of Environmental Protection shall investigate reports |
1070 | of sinkhole activity and include its findings and investigations |
1071 | in the database. |
1072 | (5) The Department of Environmental Protection, in |
1073 | consultation with the Department of Financial Services, shall |
1074 | present a report of activities relating to the sinkhole |
1075 | database, including recommendations regarding the database and |
1076 | similar matters, to the Governor, the Speaker of the House of |
1077 | Representatives, the President of the Senate, and the Chief |
1078 | Financial Officer by December 31, 2005. The report may consider |
1079 | the need for the Legislature to create an entity to study the |
1080 | increase in sinkhole activity in the state and other similar |
1081 | issues relating to sinkhole damage, including recommendations |
1082 | and costs for staffing the entity. The report may include other |
1083 | information, as appropriate. |
1084 | (6) The Department of Financial Services, in consultation |
1085 | with the Department of Environmental Protection, may adopt rules |
1086 | to implement the provisions of this section. |
1087 | Section 12. Section 627.707, Florida Statutes, is amended |
1088 | to read: |
1089 | 627.707 Minimum Standards for investigation of sinkhole |
1090 | claims by insurers; nonrenewals.-- |
1091 | (1) Upon receipt of a claim for a sinkhole loss, an |
1092 | insurer must meet the following minimum standards in |
1093 | investigating a claim: |
1094 | (1)(a) Upon receipt of a claim for a sinkhole loss, The |
1095 | insurer must make an inspection of the insured's premises to |
1096 | determine if there has been physical damage to the structure |
1097 | which may might be the result of sinkhole activity. |
1098 | (b) If, upon the investigation pursuant to paragraph (a), |
1099 | the insurer discovers damage to a structure which is consistent |
1100 | with sinkhole activity or if the structure is located in close |
1101 | proximity to a structure in which sinkhole damage has been |
1102 | verified, then prior to denying a claim, the insurer must obtain |
1103 | a written certification from an individual qualified to |
1104 | determine the existence of sinkhole activity, stating that the |
1105 | cause of the claim is not sinkhole activity, and that the |
1106 | analysis conducted was of sufficient scope to eliminate sinkhole |
1107 | activity as the cause of damage within a reasonable professional |
1108 | probability. The written certification must also specify the |
1109 | professional discipline and professional licensure or |
1110 | registration under which the analysis was conducted. |
1111 | (2) Following the insurer's initial inspection, the |
1112 | insurer shall engage an engineer and a professional geologist to |
1113 | conduct testing as provided in s. 627.7072 to determine the |
1114 | cause of the loss within a reasonable professional probability |
1115 | and issue a report as provided in s. 627.7073, if: |
1116 | (a) The insurer is unable to identify a valid cause of the |
1117 | damage or discovers damage to the structure which is consistent |
1118 | with sinkhole loss; or |
1119 | (b) The policyholder demands testing in accordance with |
1120 | this section or s. 627.7072. |
1121 | (3) Following the initial inspection of the insured |
1122 | premises, the insurer shall provide written notice to the |
1123 | policyholder disclosing the following information: |
1124 | (a) What the insurer has determined to be the cause of |
1125 | damage, if the insurer has made such a determination. |
1126 | (b) A statement of the circumstances under which the |
1127 | insurer is required to engage an engineer and a professional |
1128 | geologist to verify or eliminate sinkhole loss and to make |
1129 | recommendations regarding land and building stabilization and |
1130 | foundation repair. |
1131 | (c) A statement regarding the right of the policyholder to |
1132 | request testing by an engineer and a professional geologist and |
1133 | the circumstances under which the policyholder may demand |
1134 | certain testing. |
1135 | (4) If the insurer determines that there is no sinkhole |
1136 | loss, the insurer may deny the claim. If the insurer denies the |
1137 | claim, without performing testing under s. 627.7072, the |
1138 | policyholder may demand testing by the insured under s. |
1139 | 627.7072. The policyholder's demand for testing must be |
1140 | communicated to the insurer in writing after the policyholder's |
1141 | receipt of the insurer's denial of the claim. |
1142 | (5)(a) Subject to paragraph (b), if a sinkhole loss is |
1143 | verified, the insurer shall pay to stabilize the land and |
1144 | building and repair the foundation in accordance with the |
1145 | recommendations of the engineer and the professional geologist |
1146 | as provided under s. 627.7073, and in consultation with the |
1147 | policyholder, subject to the coverage and terms of the policy. |
1148 | The insurer shall pay for other repairs to the structure and |
1149 | contents in accordance with the terms of the policy. |
1150 | (b) The insurer may limit its payment to the actual cash |
1151 | value of the sinkhole loss until such time as expenses related |
1152 | to land and building stabilization and foundation repairs are |
1153 | incurred. |
1154 | (6) Except as provided in subsection (7), the fees and |
1155 | costs of the engineer or the professional geologist shall be |
1156 | paid by the insurer. |
1157 | (7)(c) If the insurer obtains, pursuant to s. 627.7073 |
1158 | paragraph (b), written certification that there is no sinkhole |
1159 | loss or that the cause of the damage claim was not sinkhole |
1160 | activity, and if the policyholder has submitted the sinkhole |
1161 | claim without good faith grounds for submitting such claim, the |
1162 | policyholder shall reimburse the insurer for 50 percent of the |
1163 | actual costs cost of the analyses and services provided analysis |
1164 | under ss. 627.7072 and 627.7073 paragraph (b); however, a |
1165 | policyholder is not required to reimburse an insurer more than |
1166 | $2,500 with respect to any claim. A policyholder is required to |
1167 | pay reimbursement under this subsection paragraph only if the |
1168 | insurer, prior to ordering the analysis under s. 627.7072 |
1169 | paragraph (b), informs the policyholder in writing of the |
1170 | policyholder's potential liability for reimbursement and gives |
1171 | the policyholder the opportunity to withdraw the claim. |
1172 | (8)(2) No insurer shall nonrenew any policy of property |
1173 | insurance on the basis of filing of claims for partial loss |
1174 | caused by sinkhole damage or clay shrinkage as long as the total |
1175 | of such payments does not exceed the current policy limits of |
1176 | coverage for property damage, and provided the insured has |
1177 | repaired the structure in accordance with the engineering |
1178 | recommendations upon which any payment or policy proceeds were |
1179 | based. |
1180 | (9) The insurer may engage a structural engineer to make |
1181 | recommendations as to the repair of the structure. |
1182 | Section 13. Section 627.7072, Florida Statutes, is created |
1183 | to read: |
1184 | 627.7072 Testing standards for sinkholes.-- |
1185 | (1) The engineer and professional geologist shall perform |
1186 | such tests as sufficient, in their professional opinion, to |
1187 | determine the presence or absence of sinkhole loss or other |
1188 | cause of damage within reasonable professional probability and |
1189 | to make recommendations regarding necessary building |
1190 | stabilization and foundation repair. |
1191 | (2) Testing shall be conducted in compliance with the |
1192 | Florida Geological Survey Special Publication No. 57 (2005). |
1193 | Section 14. Section 627.7073, Florida Statutes, is created |
1194 | to read: |
1195 | 627.7073 Sinkhole reports.-- |
1196 | (1) Upon completion of testing as provided in s. 627.7072, |
1197 | the engineer and professional geologist shall issue a report and |
1198 | certification to the insurer and the policyholder as provided in |
1199 | this section. |
1200 | (a) Sinkhole loss is verified if, based upon tests |
1201 | performed in accordance with s. 627.7072, an engineer and a |
1202 | professional geologist issue a written report and certification |
1203 | stating: |
1204 | 1. That the cause of the actual physical and structural |
1205 | damage is sinkhole activity within a reasonable professional |
1206 | probability. |
1207 | 2. That the analyses conducted were of sufficient scope to |
1208 | identify sinkhole activity as the cause of damage within a |
1209 | reasonable professional probability. |
1210 | 3. A description of the tests performed. |
1211 | 4. A recommendation of methods for stabilizing the land |
1212 | and building and for making repairs to the foundation. |
1213 | (b) If sinkhole activity is eliminated as the cause of |
1214 | damage to the structure, the engineer and professional geologist |
1215 | shall issue a written report and certification to the |
1216 | policyholder and the insurer stating: |
1217 | 1. That the cause of the damage is not sinkhole activity |
1218 | within a reasonable professional probability. |
1219 | 2. That the analyses and tests conducted were of |
1220 | sufficient scope to eliminate sinkhole activity as the cause of |
1221 | damage within a reasonable professional probability. |
1222 | 3. A statement of the cause of the damage within a |
1223 | reasonable professional probability. |
1224 | 4. A description of the tests performed. |
1225 | (c) The respective findings, opinions, and recommendations |
1226 | of the engineer and professional geologist as to the |
1227 | verification of a sinkhole loss, land and building |
1228 | stabilization, foundation repair, and elimination of sinkhole |
1229 | loss shall be presumed correct. |
1230 | (2) Any insurer that has paid a claim for a sinkhole loss |
1231 | shall file a copy of the report and certification, prepared |
1232 | pursuant to subsection (1), with the county property appraiser |
1233 | who shall record the report and certification with the parcel |
1234 | number. The insurer shall bear the cost of filing and recording |
1235 | the report and certification. There shall be no cause of action |
1236 | or liability against an insurer for compliance with this |
1237 | section. The seller of real property upon which a sinkhole claim |
1238 | has been made shall disclose to the buyer of such property that |
1239 | a claim has been paid and whether or not the full amount of the |
1240 | proceeds were used to repair the sinkhole damage. |
1241 | Section 15. The Auditor General shall perform an |
1242 | operational audit, as defined in s. 11.45(1), Florida Statutes, |
1243 | of the Citizens Property Insurance Corporation created under s. |
1244 | 627.351(6), Florida Statutes. The scope of the audit shall also |
1245 | include: |
1246 | (1) An analysis of the corporation's infrastructure, |
1247 | customer service, claims handling, accessibility of policyholder |
1248 | information to the agent of record, take-out programs, take-out |
1249 | bonuses, and financing arrangements. |
1250 | (2) An evaluation of costs associated with the |
1251 | administration and servicing of the policies issued by the |
1252 | corporation to determine alternatives by which costs can be |
1253 | reduced, customer service improved, and claims handling |
1254 | improved. |
1255 |
|
1256 | The audit shall contain policy alternatives for the Legislature |
1257 | to consider. The Auditor General shall submit a report to the |
1258 | Governor, the President of the Senate, and the Speaker of the |
1259 | House of Representatives no later than February 1, 2006. |
1260 | Section 16. The board of governors of the Citizens |
1261 | Property Insurance Corporation created under section 627.351(6), |
1262 | Florida Statutes, shall, by February 1, 2006, submit a report to |
1263 | the President of the Senate, the Speaker of the House of |
1264 | Representatives, the minority party leaders of the Senate and |
1265 | the House of Representatives, and the chairs of the standing |
1266 | committees of the Senate and the House of Representatives having |
1267 | jurisdiction over matters relating to property and casualty |
1268 | insurance. The report shall include the board's findings and |
1269 | recommendations on the following issues: |
1270 | (1) The number of policies and the aggregate premium of |
1271 | the Citizens Property Insurance Corporation, before and after |
1272 | enactment of this act, and projections for future policy and |
1273 | premium growth. |
1274 | (2) Increases or decreases in availability of residential |
1275 | property coverage in the voluntary market and the effectiveness |
1276 | of this act in improving the availability of residential |
1277 | property coverage in the voluntary market in the state. |
1278 | (3) The board's efforts to depopulate the corporation and |
1279 | the willingness of insurers in the voluntary market to avail |
1280 | themselves of depopulation incentives. |
1281 | (4) Further actions that could be taken by the Legislature |
1282 | to improve availability of residential property coverage in the |
1283 | voluntary and residual markets. |
1284 | (5) Actions that the board has taken to restructure the |
1285 | corporation and recommendations for legislative action to |
1286 | restructure the corporation, including, but not limited to, |
1287 | actions relating to claims handling and customer service. |
1288 | (6) Projected surpluses or deficits and possible means of |
1289 | providing funding to ensure the continued solvency of the |
1290 | corporation. |
1291 | (7) The corporation's efforts to procure catastrophe |
1292 | reinsurance to cover its projected 100-year probable maximum |
1293 | loss with specification as to what best efforts were made by the |
1294 | corporation to procure such reinsurance. |
1295 | (8) Such other issues as the board determines are worthy |
1296 | of the Legislature's consideration. |
1297 | Section 17. Sections 3 and 4 of this act shall take effect |
1298 | on the same date that House Bill 1939 or similar legislation |
1299 | takes effect, if such legislation is adopted in the same |
1300 | legislative session or an extension thereof and becomes a law. |
1301 | Section 18. Except as otherwise provided herein, this act |
1302 | shall take effect July 1, 2005. |